Insurance Inclusion

How specific does an insurance policy need to be?

Wouldn't it be nice just to be "insured" for everything? Just buy one comprehensive policy to take care of anything bad that might happen.

Lose a boyfriend and break your heart?

You're covered. Buy some alcohol with the policy proceeds.

Sleep through the alarm and lose your job?

No problem - you're covered. Start your own business with the policy proceeds.

Wake up in a bad mood and go on a shooting rampage?

Don't worry about it. Your defense costs are covered.

We know, though, that insurance doesn't work that way. In fact, policies tend to be as specific as possible so that insurance companies can find creative ways to avoid paying.

E. g. - Yes, your house was blown away by a tornado but, due to global warming, this was not a covered act of God. Additionally, the fact that your cat was in the home and could have taken precautions, means that you were partly to blame.

That's the sort of thing we see litigation over: insurance policy exclusions.

So I was pretty surprised to see a proposed class action filed against Blue Shield in Los Angeles the other day for an inclusion - maternity coverage.

According to the suit, Blue Shield is charging men for maternity care even though they can't possibly use it. I'm not sure why they didn't include old maids and nuns in the class, but maybe that suit is coming.

Apparently the plaintiff (or his lawyers) thinks he should pay less since he's not getting everything that women get.

Or is he?

Can you spot the problem here?

There just might be a thing or two that men get but women don't (or at least not as often) - like prostate cancer.

Or erectile dysfunction.

Do women want to pay for those things?

Now imagine the uproar if this class action succeeds and insurance companies start charging women more than men for insurance.

I can see years of delightful litigation.

There are two possible solutions - specificity and non-specificity.

You can sell insurance polices with boxes to check for medical problems that you want covered. Then, naturally, you'll come down with something not on the list.

Or you can sell insurance policies that cover everything that's not self-inflicted.

And then we'll get litigation over whether bad eating habits are self-inflicted....

SWITCHED AT NON-BIRTH. As I've said many a time before, honesty isn't always the best policy. I'm not lying about this.

You may have read about the latest example - a suit by a Texas couple against a funeral home and a medical center for burying a big toe instead of a five-month-old fetus who died in the womb.

Tragic, yes, but it wouldn't have led to litigation if only a doctor hadn't had a sudden bout of inexplicable honesty - he called the parents and told them about the toe just two hours after the burial.

They hadn't noticed before. The toe, perhaps, had some sort of family resemblance.

So the only reason for the lawsuit was the doctor's honesty. Without it, no one would have been more traumatized.

Let this be a lesson to those of you who like to own up to things.

Subscribe to Closing Arguments

Sign up for new weekly newsletter Closing Arguments to get the latest about ongoing trials, major litigation and hot cases and rulings in courthouses around the U.S. and the world.

Email *

Submit